Comparative Evaluation of Compression Systems in Venous Ulcers: Results in Edema, Scarring, and Patient Well-Being in the Short Term

Objective: To evaluate the effectiveness of different compression therapy (CT) systems for providing edema reduction, wound healing, and patient comfort during the treatment of venous leg ulcers (VLUs). Methodology: A multicenter study was carried out in four Andalusian provinces with 140 patients with active VLUs. The target population consisted of patients with active VLUs referred to the Advanced Practice Nurses in Complex Chronic Wounds APN-CCW during the study period, which ran from January 2024 to July 2025. The inclusion criteria were: VLU patients over 18 years of age, with an Ankle-Brachial Index between 0.9 and 1.3, and with exudate and scarring that would allow twice weekly dressing changes. The exclusion criteria were: Patients with wound types other than VLUs, with an inability to give informed consent, or with less than one year expected mortality. Patients were treated with 6 different types of compression therapy for 4 days, in accordance with manufacturers’ instructions. The pressures were monitored daily using a wearable pressure sensing device and connected digital platform. Leg circumference, RESVECH 2.0 score, mean improvement in wound condition, mean improvement in wound surface area average, and patient comfort level were analyzed. Results: CT significantly reduced edema, with a mean leg circumference reduction between 0.9 to 1.4 cm in four days. No differences were observed when grouping the participants by sex, age, or BMI. At the end of the study period, 21.4% of participants had achieved complete ulcer healing, and non-healed participants achieved a mean reduction of 2.6 points in the RESVECH scale. Although no statistically significant differences were found between the different compression systems, CPK Compress 2 and Urgo K2 showed the highest rates of healing, while Urgo K1 and Jobst Compri2 showed the lowest. This suggests possible variations in initial efficacy that merit further investigation. Patient comfort was highly satisfactory, with 93.8% of participants rating the compression as comfortable. The absence of significant differences in comfort across sex, age, obesity, or type of compression system, combined with the low number of bandage removals, reinforces the idea that CT is well tolerated and provides clear therapeutic benefits. Conclusions: The CT reduced edema and promoted healing in VLU patients, regardless of the compression system used. No significant differences were observed between compression systems in reduction of edema or healing outcomes. Patients reported high levels of comfort with all compression systems.